产前 EPA 和 DHA 对母血和脐血胰岛素敏感性的影响：母亲、ω-3 和心理健康研究的二次分析。

Effect of prenatal EPA and DHA on maternal and cord blood insulin sensitivity: a secondary analysis of the mothers, omega 3, and mental health study.

机构信息

Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin, MSB 3.286, Houston, 77030, USA.

Department of Obstetrics and Gynecology, University of New Mexico, 915 Camino de Salud NE, MSC10-5580, Albuquerque, 87131, USA.

出版信息

BMC Pregnancy Childbirth. 2019 Nov 29;19(1):452. doi: 10.1186/s12884-019-2599-6.

DOI:10.1186/s12884-019-2599-6

PMID:31783739

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6883625/

Abstract

BACKGROUND

We sought to determine whether prenatal supplementation with the omega-3 fatty acids eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) would increase markers of insulin sensitivity in maternal or cord blood compared with placebo supplementation. A secondary aim was to evaluate the association of serum EPA and DHA fractions with adiponectin, leptin and the adiponectin:leptin ratio (ALR). We hypothesized that omega-3 fatty acid supplementation would increase markers of insulin sensitivity in maternal and umbilical cord plasma.

METHODS

We analyzed stored plasma samples collected from a prior 3-arm prospective, double-blinded, randomized controlled trial in which 126 women with singleton pregnancies between 12- and 20-weeks' gestation were randomized to receive: 1) an EPA-rich fish oil supplement, 2) a DHA-rich fish oil supplement, or 3) a soy oil placebo. Maternal venous blood samples were collected at 12-20 weeks gestation (before supplementation) and at 34-36 weeks gestation. At delivery, cord blood was collected. Samples were analyzed using sandwich enzyme-linked immunosorbent assay kits to quantify leptin and adiponectin levels which were utilized to calculate the ALR, a proxy measure for insulin sensitivity.

RESULTS

We found no difference in adiponectin, leptin, and the ALR between the treatment and placebo groups at baseline, after supplementation, or in umbilical cord blood. In regression analyses, higher maternal serum DHA fraction was associated with increased ALR before (p = 0.01) and after (p = 0.04) DHA supplementation. There was no association of EPA fraction with any measure of insulin sensitivity. Cord blood DHA fraction was significantly associated with cord plasma leptin (p = 0.02). Early pregnancy BMI was significantly associated with maternal leptin levels at baseline and in late pregnancy (p < 0.001) and was inversely associated with the ALR (p < 0.001). The ALR decreased significantly between the early and late pregnancy visits (p < 0.001). Pregnancy weight gain was inversely associated with the ALR (P. < 0.02).

CONCLUSIONS

EPA- and DHA- rich fish oil supplementation had no effect on plasma markers of insulin sensitivity. However, maternal serum DHA fraction was significantly associated with markers of insulin sensitivity.

TRIAL REGISTRATION

https://clinicaltrials.gov/, registration number NCT00711971, 7/7/2008.

摘要

背景

我们旨在确定与安慰剂补充相比，产前补充ω-3 脂肪酸二十碳五烯酸（EPA）或二十二碳六烯酸（DHA）是否会增加母体或脐带血中胰岛素敏感性的标志物。次要目的是评估血清 EPA 和 DHA 分数与脂联素、瘦素和脂联素：瘦素比值（ALR）的关系。我们假设ω-3 脂肪酸补充剂会增加母体和脐带血浆中胰岛素敏感性的标志物。

方法

我们分析了先前前瞻性、双盲、随机对照三臂试验中储存的血浆样本，该试验纳入了 126 名单胎妊娠 12-20 周的孕妇，随机分为三组：1）富含 EPA 的鱼油补充剂，2）富含 DHA 的鱼油补充剂，或 3）大豆油安慰剂。母体静脉血样本在妊娠 12-20 周（补充前）和 34-36 周时采集。分娩时采集脐带血。使用夹心酶联免疫吸附试验试剂盒分析样本，以定量检测瘦素和脂联素水平，然后计算 ALR，这是胰岛素敏感性的替代指标。

结果

我们发现，在基线时、补充后或脐带血中，治疗组与安慰剂组之间的脂联素、瘦素和 ALR 无差异。在回归分析中，母体血清 DHA 分数与补充前（p=0.01）和补充后（p=0.04）的 ALR 升高有关。EPA 分数与任何胰岛素敏感性指标均无关联。脐带血 DHA 分数与脐带血浆瘦素显著相关（p=0.02）。早期妊娠 BMI 与基线和晚期妊娠时的母体瘦素水平显著相关（p<0.001），与 ALR 呈负相关（p<0.001）。ALR 在早孕期和晚孕期就诊期间显著下降（p<0.001）。妊娠体重增加与 ALR 呈负相关（P<.02）。